Download How is the pathology of Type 2 diabetes mellitus different than Type

How is the pathology of Type 2 diabetes mellitus different than Type 1 diabetes mellitus?
Also known as
The breakdown
Ages affected
Types
Causes
Pathophysiology
Insulin
Glucagon
Amylin- a hormone co-secreted
with insulin by the beta cellsusually suppresses glucagon
Type 1 Diabetes
IDDM or juvenile onset**
Accounts for 5-10 % of all cases
of diabetes
Peak onset at age 11-13
a) Immune- cell mediated
destruction of beta cells
of pancreas
b) Nonimmune- idiopathic
cases such as
pancreatitis, tumors of
the pancreas
Mixed genetic and
environmental
a) Genetic- between 1013% have a first degree
relative with type I
In immune type there is an
autoimmune reaction to
antigens of the islet cells of the
pancreas, leading to destruction
of the beta cells leading to a
deficiency in insulin secretion.
Macrophages, T and B
lymphocytes, and natural killer
cells are held responsible for
destruction
Not enough is produced
There is excessive secretion of
glucagon in these patients
relative to insulin secretion
because the alpha cells are also
functioning abnormally.
Deficient
Type 2 Diabetes
NIDDM or adult onset
Accounts for 90-95% of all cases
of diabetes
Affects people primarily after 40
yrs of age
a) Maturity onset diabetes
of youth**
b) Gestational diabetes
c) Regular type II diabetes
Mixed genetic and risk factors
such as obesity, advanced age,
physical inactivity, prior history
of gestational diabetes mellitus
(GDM), family history of
diabetes, hypertension,
dyslipidemia, polycystic ovary
syndrome (PCOS) and
race/ethnicity (African
Americans, Latino, Hispanic,
American Indians)
a) Insulin resistance:
suboptimal response of
insulin sensitive cells to
insulin
b) Decreased insulin
secretion by beta cells:
amyloid infiltration of
islets and islet cell
destruction
Cells become resistant to it
and/or production is decreased
Not as big of a player
Deficient
secretion
Consequences for metabolism
Relative increase in glucagon
stimulates overproduction of
glucose and ketones; deficiency
of insulin results in an increase in
fat catabolism
Hyperglycemia d/t insulin
resistance or underproduction of
insulin leads to abnormal lipid
synthesis, fatigue, and increased
gluconeogenesis
**This has been further confused by maturity type onset diabetes of the young (MODY)- a form of
diabetes type II that affects people under the age of 25.
Here are a few more concept maps that we created to help us put it all together
TYPE I DIABETES
TYPE II DIABETES
References
American Diabetes Association (2008). DiabetesPro: Professional resources online. Retrieved February 3,
2009 from http://professional.diabetes.org/Disease_Backgrounder.aspx?MID=230&RD=1.
King, M. (2008). Definition of diabetes. Retrieved February 2, 2009 from
http://themedicalbiochemistrypage.org/diabetes.html.
McCance, K.L., & Huether, S.E. (2006). Pathophysiology: The biologic basis for disease in adults and
children (5th ed.). St. Louis: Elsevier Mosby.